Downloaded from https://www.everyspec.com (3) In view of the Soldier’s condition, his or her retention in the military service would prejudice the best interests of the Government (for example, a carrier of communicable disease who poses a health threat to others). Questionable cases, including those involving latent impairment, will be referred to PEBs. 3–42. Malignant neoplasms The causes for referral to an MEB are as follows: a. Malignant neoplasms that are unresponsive to therapy, or when the residuals of treatment are in themselves unfitting under other provisions of this chapter. b.
Neoplastic conditions of the lymphoid and blood-forming tissues that are unresponsive to therapy, or when the residuals of treatment are in themselves unfitting under other provisions of this chapter. c. Malignant neoplasms, when on evaluation for administrative separation or retirement, the observation period subsequent to treatment is deemed inadequate in accordance with accepted medical principles. d. The above definitions of malignancy or malignant disease exclude basal cell carcinoma of the skin. 3–43. Benign neoplasms The causes for referral to an MEB are as follows: a. Benign tumors if their condition precludes the satisfactory performance of military duty. b. Ganglioneuroma. c.
Meningeal fibroblastoma, when the brain is involved. d. Pigmented villonodular synovitis when severe enough to prevent successful performance of duty. 3–44. Sexually transmitted diseases The causes for referral to an MEB are as follows: a. Symptomatic neurosyphilis in any form. b. Complications or residuals of a sexually transmitted disease of such chronicity or degree that the individual is incapable of performing useful duty. 3–45. Heat illness and injury The causes for referral to an MEB are as follows: a. Heat exhaustion.
(1) Heat exhaustion is defined as collapse, including syncope, occurring during or immediately following exer- cise–heat stress without evidence of organ damage or systemic inflammatory activation. (2) Individual episodes of heat exhaustion are not cause for MEB referral. However, Soldiers suffering from recurrent episodes of heat exhaustion (three or more in less than 24 months) should be referred for complete medical evaluation for contributing factors. (3) If no remediable factor causing recurrent heat exhaustion is identified, then the Soldier will be referred to an MEB. b. Heat stroke. (1) The definitions of heat stroke are as follows: (a) Heat stroke:
A syndrome of hyperpyrexia, collapse, and encephalopathy with evidence of organ damage and/or systemic inflammatory activation occurring in the setting of environmental heat stress. (b) Exertional rhabdomyolysis: Rhabdomyolysis with myoglobinuria occurring with exercise–heat stress but without the encephalopathy of heat stroke. (2) Soldiers will be referred to an MEB after an episode of heat stroke or exertional rhabdomyolysis. If the Soldier has had full clinical recovery, and particularly if a circumstantial contributing factor to the episode can be identified, the MEB may recommend a trial of duty with a P–3 (T) profile.
The profile will restrict the Soldier from performing vigorous physical exercise for periods longer than 15 minutes. Maximal efforts, such as the APFT 2-mile run are not permitted. If, after 3 months, the Soldier has not manifested any heat intolerance, the profile may be modified to P–3 (T) and normal unrestricted work permitted. Maximal exertion and significant heat exposure (such as wearing Mission Oriented Protective Posture (MOPP) IV) are still restricted. If the Soldier manifests no heat intolerance, including a season of significant environmental heat stress, normal activities can be resumed and the Soldier may be returned to duty without a PEB.
Any evidence of significant heat intolerance, either during the period of the profile or subsequent- ly, requires a referral to a PEB. (A description of the heat intolerance should be included in the MEB narrative summary.) 3–46. Cold injury The causes for referral to an MEB are as follows: a. Frostbite (freezing cold injury) . (1) The definition of frostbite is the consequence of freezing of tissue. First degree frostbite is manifested by 36 AR 40–501 • 14 December 2007